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RCCG, RESTORATION ARENA
SUNDAY IN-PERSON SERVICE SIGN UP
10
Questions
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1
Service Day & Time
*
This field is required.
Please select this coming Sunday's date and a time slot.
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2
Full Name
*
This field is required.
First Name
Last Name
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3
E-mail
Optional
example@example.com
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4
Will this be your first time attending an in-person service at Restoration Arena?
*
This field is required.
First Timers Only
Yes
No
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5
Asides yourself, how many people will be attending?
*
This field is required.
0
1
2
3
4
5
6
7 or more
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6
Use your no-touch thermometer.
Is your temperature or the temperature
of anyone coming to church with you,
greater than or equal to 100.0 degrees Fahrenheit?
*
This field is required.
All information entered is confidential
YES
NO
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7
Have you had any
known close contact
with a
person confirmed or suspected
to have
COVID-19
in the
past 14 days
?
*
This field is required.
Please note close contact does not include individuals who work in a health care setting and are wearing appropriate, required personal protective equipment (PPE).
YES
NO
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8
Have you traveled within a state with significant community spread of COVID-19 for longer than 24 hours within the past 14 days?
*
This field is required.
For a list of states currently under New York’s Travel Advisory requiring a 14-day quarantine upon return, please visit https://coronavirus.health.ny.gov/covid-19-travel-advisory
YES
NO
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9
Have you tested positive for COVID-19 through a diagnostic test in the past 14 days?
*
This field is required.
YES
NO
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10
Are you currently experiencing ANY of the following: new or worsening cough, shortness of breath/difficulty breathing, sore throat, new muscle aches or headaches, fever, gastrointestinal symptoms (i.e. diarrhea, vomiting, etc.), chills or repeated shaking with chills, or a new loss of taste or smell?
*
This field is required.
Please note a few of the above symptoms may occur with preexisting medical conditions, such as allergies or migraines. You should only answer “YES”, if your symptoms are new or worsening.
YES
NO
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RCCG, RESTORATION ARENA: SUNDAY IN-PERSON SERVICE SIGN UP
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